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National Symposium on Value Innovation at Yale

April 27 - April 29, 2016

Omni New Haven Hotel at Yale
New Haven, Connecticut

The inaugural National Symposium on Value Innovation at Yale will demonstrate how collaboration and best practices help deliver better patient care, more efficiently and effectively than others, while sustaining or improving financial performance. Industry leaders and thought provokers will provide a vision for the future of healthcare management.

Yale New Haven Health will share its “quality-first” approach that reduced variation, improved clinical outcomes and yielded $150 million in savings.

In collaboration with the Yale School of Management, the Center for Outcomes Research & Evaluation and the Center for Biomedical and Interventional Technology, they are sharing their model with other systems in order to accelerate the transition to delivering value-based care.

Marna Borgstrom

President and CEO of Yale New Haven Health System and CEO of Yale-New Haven Hospital

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Marna Borgstrom
President and CEO of Yale New Haven Health System and CEO of Yale-New Haven Hospital

Marna Borgstrom began her career at Yale-New Haven Hospital more than 30 years ago. Her varied roles have taken her from a post-graduate fellowship, to various staff and management roles, to her 1994 promotion to the position of Executive Vice President and Chief Operating Officer. In 2005, she was appointed President and CEO of both Yale-New Haven Hospital and Yale New Haven Health System.

The Yale New Haven Health System, which has $2 billion in revenues and employs 13,000 people in Connecticut, includes Bridgeport and Greenwich Hospitals as well.

She serves on several national boards, including VHA, Inc. in Dallas, the Council of Teaching Hospitals and Healthcare Executives Study Society. Closer to home, she serves on the Connecticut Hospital Association’s Board of Trustees and Greater New Haven Regional Leadership Council. She was previously Chair of the Connecticut Hospital Association’s Board of Trustees and served on the Boards of the Hole in the Wall Gang Camp, the United Way of Greater New Haven and the Greater New Haven Chamber of Commerce’s Board and Executive Committee.

Marna has been the recipient of several awards recognizing her community involvement, including ADL’s Torch of Liberty Award, YMCA’s Women In Leadership Award, Junior Achievement Hall of Fame, New Haven Business Times’ 20 Noteworthy Women, Hill Health Center’s Leadership Award, Connecticut Women in Leadership Award and she is a member of the Gateway Community College Hall of Fame.Marna Borgstrom began her career at Yale-New Haven Hospital more than 30 years ago. Her varied roles have taken her from a post-graduate fellowship, to various staff and management roles, to her 1994 promotion to the position of Executive Vice President and Chief Operating Officer. In 2005, she was appointed President and CEO of both Yale-New Haven Hospital and Yale New Haven Health System. The Yale New Haven Health System, which has $2 billion in revenues and employs 13,000 people in Connecticut, includes Bridgeport and Greenwich Hospitals as well. She serves on several national boards, including VHA, Inc. in Dallas, the Council of Teaching Hospitals and Healthcare Executives Study Society.

Closer to home, she serves on the Connecticut Hospital Association’s Board of Trustees and Greater New Haven Regional Leadership Council. She was previously Chair of the Connecticut Hospital Association’s Board of Trustees and served on the Boards of the Hole in the Wall Gang Camp, the United Way of Greater New Haven and the Greater New Haven Chamber of Commerce’s Board and Executive Committee. Marna has been the recipient of several awards recognizing her community involvement, including ADL’s Torch of Liberty Award, YMCA’s Women In Leadership Award, Junior Achievement Hall of Fame, New Haven Business Times’ 20 Noteworthy Women, Hill Health Center’s Leadership Award, Connecticut Women in Leadership Award and she is a member of the Gateway Community College Hall of Fame.

Steve Allegretto is the Vice President, Strategic Analytics and Financial Planning for the Yale-New Haven Health System, a $3.5B health system with over 20,000 employees located primarily in Connecticut. He has been at Yale-New Haven Hospital/Yale New Haven Health System for close to 30 years, serving in a variety of financial and operational roles. He is a certified public accountant with an undergraduate degree in economics from Fairfield University and a master’s degree in public health from Yale University. He has had various teaching responsibilities at Yale School of Medicine’s Epidemiology and Public Health Program, Quinnipiac University and Sacred Heart University. Steve has a deep interest in demonstrating how the actual application of integrated clinical, operational and financial data drives actual improvement in patient care quality and cost while creating opportunities for value innovation.

W. Mark Saltzman is an engineer and educator. His research has impacted the fields of drug delivery, biomaterials, nanobiotechnology, and tissue engineering: this work is described in more than 300 research papers and patents. He is also the sole author of three textbooks: Biomedical Engineering (Second Edition, 2015), Tissue Engineering (2004), and Drug Delivery (2001).

The grandson of farmers from southern Iowa, Mark Saltzman graduated with distinction from Iowa State University with a B.S. in chemical engineering (1981), earning admission to graduate school at the Massachusetts Institute of Technology, where he received an S.M. in chemical engineering (1984) and a Ph.D. in medical engineering (1987). He was appointed assistant professor of chemical engineering at Johns Hopkins University in 1987 and promoted through the ranks, becoming a tenured full professor in 1995. In 1996, he joined the faculty of chemical engineering at Cornell University, where he was named the first BP Amoco/H. Laurance Fuller Chair in Chemical Engineering. Dr. Saltzman moved to Yale University as the Goizueta Foundation Professor of Chemical and Biomedical Engineering in July of 2002, and served as the founding chair of Yale’s Department of Biomedical Engineering in 2003-2015.

Dr. Saltzman has been recognized widely for his excellence in research and teaching. He has received the Camille and Henry Dreyfus Foundation Teacher-Scholar Award (1990); the Allan C. Davis Medal as Maryland’s Outstanding Young Engineer (1995); the Controlled Release Society Young Investigator Award (1996); the Professional Progress in Engineering (2000) and Professional Achievement Citation in Engineering (2013) Awards from Iowa State University (2000). He has been honored by election as a Fellow of the American Institute for Medical and Biological Engineering (1997); a Fellow of the Biomedical Engineering Society (2010); a Member of the Connecticut Academy of Science & Engineering (2012); a Fellow of the National Academy of Inventors (2013), and an elected Member of the US National Academy of Medicine (2014). He has delivered over 275 invited lectures throughout the world.

Over the past 3 decades, Dr. Saltzman has taught dozens of college courses including Heat & Mass Transfer, Material & Energy Balances, Introduction to Biomedical Engineering, Drug Delivery & Tissue Engineering, Physiological Systems, and Molecular Transport & Intervention in the Brain. His course Frontiers of Biomedical Engineering is available to everyone through Open Yale Courses (http://oyc.yale.edu).

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Dan Michelson

Chief Executive Officer, Strata Decision Technology

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Dan MichelsonChief Executive Officer, Strata Decision Technology

Dan is the CEO of Strata Decision Technology, a pioneer and leader in the development of innovative cloud-based solutions for financial analytics, business intelligence and decision support. The Company’s solutions are used by over 1,000 healthcare organizations, including many of the largest and most influential healthcare systems in the U.S. Strata Decision provides a single platform for strategic planning, financial forecasting, budgeting, capital planning and tracking, performance management and decision support.

With over 25 years of healthcare experience, Dan’s focus as CEO is to ensure the company delivers on its passion – helping hospitals and health networks drive margin to fuel their mission.

Over the last decade, Dan has become one of the industry’s high impact thought leaders in developing the healthcare information technology market. He has been a central player in bringing electronic health records mainstream and has been instrumental in driving standards by serving as one of the original members of the Certification Commission for Healthcare Information Technology and helping to start the EHR Vendor Trade Association. He has been a frequent speaker at industry conferences.

Prior to joining Strata Decision Technology, Dan served as Chief Marketing and Strategy Officer for Allscripts Healthcare Solutions. In his 12 years at Allscripts, he was one of the executive leaders responsible for growing the company from 100 to over 6,000 employees and from $26 million to over $1.4 billion in annual revenue.

Prior to joining Allscripts, he provided strategy and process redesign consulting for many of the leading hospitals and health systems in the U.S. He also served in leadership roles for Baxter International, a leading medical supply company, and AstraZeneca, one the world’s largest pharmaceutical companies.

He earned his BS in Finance from Indiana University and his MBA from DePaul University. He is an avid runner, having completed 12 marathons. He is the co-founder of projectMUSIC™, a benefit concert that sends underprivileged children to overnight camp.

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Stephanie Alexander

Chief Executive Officer, PeraHealth

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Stephanie AlexanderChief Executive Officer, PeraHealth

Stephanie Alexander is recognized internationally as a pioneer in using healthcare IT and big data to help providers better coordinate care and drive improvements in quality, safety and efficiency.

A healthcare industry veteran with close to three decades of experience, Alexander built Premier’s (NASDAQ: PINC) IT business from $1 million to $100 million in revenue, and pioneered the development of the nation’s largest clinical benchmarking database. She served as executive sponsor of the Centers for Medicare & Medicaid Services’ (CMS) Hospital Quality Improvement Demonstration (HQID) project, a first-of-its-kind initiative that is the foundation for CMS’s value-based purchasing program. She also provided executive oversight for a United Kingdom program modeled after HQID. Prior to joining PeraHealth in December 2012, Alexander was president of Performance Analytics and Decision Support Services at MedAssets (NASDAQ: MDAS).

Alexander has extensive experience in managing healthcare mergers and acquisitions, and developing strategic growth plans. She led Premier’s acquisition of technology startup Cereplex Inc, and of CareScience, which combined two of the nation’s leading clinical informatics technologies. She also led MedAssets’ supply-chain technology integration and project management for its Broadlane acquisition.

Alexander holds a Bachelor of Science in Industrial Engineering from North Carolina State University and a Master of Business Administration from the University of North Carolina at Chapel Hill.

Lisa Stump is a dynamic health care leader with 20 years of clinical, operational, and information technology experience. As the Interim CIO at Yale New Haven Health System (YNHHS), she leads and directs a team of 600 IT professionals supporting applications, analytics, clinical engineering, imaging technology, and IT infrastructure for the hospitals and physician practices of YNHHS and The Yale School of Medicine aligning ITS strategy with organizational goals to advance care and research. Lisa is also Adjunct Professor at Sacred Heart University in the Healthcare Informatics Program and Assistant Clinical Professor at the Yale School of Nursing Division of Primary Care and Health Systems.

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Thomas Balcezak, MD

Thomas joined the Hospital in 1992 and is responsible for medical staff affairs, graduate medical education, patient safety and clinical quality, accreditation and regulatory affairs, the Hospitalist service and care management. He received his MD degree from University of Connecticut and Master’s in Public Health from Yale. He completed his residency in Internal Medicine at YNHH, and is an Associate Clinical Professor of Medicine and Lecturer in Public Health at Yale School of Medicine.

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Fiona Scott Morton, PhD

Fiona Scott-Morton is the Theodore Nierenberg Professor of Economics at the Yale University School of Management where she has been on the faculty since 1999. Her area of academic research is empirical industrial organization, with a focus on empirical studies of competition in areas such as pricing, entry, and product differentiation. Her published articles range widely across industries, from magazines, to shipping, to pharmaceuticals, to internet retailing, and are published in leading economics journals. From 2011-12 Professor Scott Morton served as the Deputy Assistant Attorney General for Economics at the Antitrust Division of the U.S. Department of Justice, where she helped enforce the nation’s antitrust laws. At Yale SOM she teaches courses in the area of competitive strategy. She served as Associate Dean from 2007-10 and in 2007 she won the School’s teaching award. She has served in an editing role on various academic economics journals, has won several research grants from the National Science Foundation, and is a Research Associate at NBER. Professor Scott Morton has a BA from Yale and a PhD from MIT, and previously taught at the Graduate Schools of Business at the University of Chicago and Stanford University. She is a frequent speaker at seminars and conferences across the United States and Europe. Professor Scott Morton lives in New Haven, Connecticut with her husband and three children.

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Harlan Krumholz, MD

Harold H. Hines, Jr., Professor of Medicine and Epidemiology and Public Health, Yale School of Medicine; Director, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital

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Harlan Krumholz, MDHarold H. Hines, Jr., Professor of Medicine and Epidemiology and Public Health, Yale School of Medicine, Director, Center for Outcomes Research and Evaluation, Yale-New Haven Hospital

Harlan Krumholz is a cardiologist and health care researcher at Yale University and Yale-New Haven Hospital. He received a BS from Yale, an MD from Harvard Medical School, and a Masters in Health Policy and Management from the Harvard University School of Public Health. He is the Harold H. Hines, Jr. Professor of Medicine and Director of the Yale Center for Outcomes Research and Evaluation (CORE), one of the nation’s first and most productive research units dedicated to producing innovations to improve patient outcomes and promote better population health. He is also a Director of the Robert Wood Johnson Foundation Clinical Scholars Program, which prepares talented physicians to become future health care leaders.

Dr. Krumholz has been honored by membership in the Institute of Medicine, the Association of American Physicians, and the American Society for Clinical Investigation. He was named a Distinguished Scientist of the American Heart Association. He was elected to the Board of Trustees of the American College of Cardiology and the Board of Directors of the American Board of Internal Medicine, and was appointed by the U.S. government to the Board of Governors of the Patient-Centered Outcomes Research Institute. He is a 2014 recipient of the Friendship Award from the People’s Republic of China in recognition of his collaborative efforts to develop a national cardiovascular research network.

Dr. Krumholz is the editor of Circulation: Cardiovascular Quality and Outcomes, and editor of CardioExchange, a social media site of the publisher of the New England Journal of Medicine. He has published more than 800 articles and is the author of two books, one on smoking cessation and another on reducing the risk of heart disease. He has a regular blog on Forbes.com and has contributed to the New York Times Wellness blog, the New York Times op-ed page, and National Public Radio Shots blog.

I graduated from the Medical Scientist Training Program at Baylor College of Medicine with an MD and a PhD in Immunology. My surgical and urologic training was at Johns Hopkins Hospital in Baltimore, Maryland. Following a brief period at Baylor in Houston, I was recruited as the Chief of Minimally Invasive Surgery in the Department of Urology at UCLA. At UCLA, I developed laparoscopic and robotic surgery programs for prostate and kidney cancer. I was also the Surgical Director of the Living Kidney Donor Program and performed over 1,200 laparoscopic living donor kidney procedures. At UCLA, I became the vice chair of the department and was actively involved in improving the patient experience throughout the hospital. In January of 2012, I became the Chair of the Department of Urology at Yale. My focus is to build a program that can offer every patient with any urologic condition state of the art diagnosis and treatment in an environment that is patient centered. We are committed to listening and engaging the patient in their care. In addition, we strive to assure open communication between our team, the patient, the patient’s family and the primary care physicians. We want every patient to receive innovative, state of the art care but just as important we want our physicians, nurses and staff to treat every patient with compassion and kindness.

Track One: Integration, Scale and New Partnerships

In this session we will explore YNHHS’ focus on developing an integrated network that provides a full continuum of high-quality, cost-effective care to better serve our communities to include specific integration examples and strategies. We will describe key accomplishments that included consolidating clinical services, the onboarding of close to 4,000 employees, meeting all regulatory requirements, investing in infrastructure enhancements, decreasing overall operating costs and maintaining financial performance.

In this session we will demonstrate how robust cost accounting data, combined with EMR and quality data, allowed leaders to identify variations in clinical quality and cost. We will then explore how the data led to actions that improved quality and lowered costs, and continues to facilitate collaboration across organizations and drive opportunities to impact healthcare organization, delivery and reimbursement.

A3. The Role of Interdisciplinary Innovation: “Intrapreneurship” and Strategic Partnerships:

In this session we will explore how the Center for Biomedical and Interventional Technology and YNHHS are aligning efforts to engage payors and develop strategic partnerships with industry leaders to address clinical pain points that lead to care and cost variation. We will outline methods for turning ideas into organizational intellectual property with the mindset of progression to commercial products while providing a path to building “intrapreneurship”.

In this session we will describe the use of over 5,000 data elements belonging to cardiac patients by the Center for Outcomes Research and Evaluation (CORE) to develop a predictive model for Quality Variation Indicators. The presenters will discuss the model-building as it applies to patients who undergo CABG, valve surgery and PTCA.

A5. The Drivers of Improved Value for Heart and Vascular Destination Services:

In this session you will learn how to profile clinical and financial variation for a service line with significant clinical variation driven by complex patients who are crucial to YNHH’s mission and vision – patients transferred in from other hospitals. These patients, however were leading to increased Medicare penalties and significant outcomes variation. We will describe how readily available administrative data can be reliably used for profiling and how engaged clinical leaders were able to drive meaningful conversations with clinicians by integrating Rothman Index data with clinical registry data to highlight variation in care practices and improve quality and cost variation.

A6. Integrate, Innovate and Invigorate: The Center for Musculoskeletal Care and Bundled Payments:

In this session we will demonstrate how a new surgeon’s leadership and vision supporting a new patient-centered model of care combined with historical knowledge and data – a $3m annual implant standardization opportunity that existed for the last five years—to drive FY 2016 improvements in clinical quality and cost. The non-salary cost variation data will be supplemented with trended clinical variation data. We will then explore YNHHS’ movement into the CMS BPCI bundled payments program and the identification of an infrequently used gainsharing program called the Internal Cost Savings (ICS) program which allowed the organization to align efforts at the patient and surgeon level. Initial program results for FY 2016 (Quarter 1) are showing improved quality, a greater than 11% reduction in implant cost and gain-sharing distributions.

Track Two: High Reliability, Technology and Innovation

In this session we will explore the “inventory” of technology systems currently deployed and planned for deployment that ensure that we have a full understanding of our patients’ needs and experiences and the impact on quality and cost. We will then explore how these systems combined with our vision for a fully personalized patient health record will enhance our value to our patients.

In this session you will learn what it means to be a high-reliability organization and how YNHHS’ code-based quality system (QVIs) is combined with cost and EMR data to allow clinicians to measure clinical improvements over time. Specifically, we will explore two patient populations – those with sickle cell disease and those undergoing lower joint replacement with a recently implemented early recovery after surgery (ERAS) program. Results will show the cumulative and sustained clinical and financial improvements in both groups. The sickle cell disease program alone resulted in significant clinical improvements and a savings of $7m over three years.

In this session, leaders will describe their practical experiences and present their thoughts on how we are creating real opportunities for academia to partner in new ways to solve complex clinical care and cost variation issues. This dialogue will discuss lessons learned as well as outline the journey ahead of us to develop leaders who incorporate innovative solutions into the many challenges faced by patients, clinicians and hospitals.

B4. The Role of Early Identification in the Deterioration of Patients’ Condition: Right Patient, Right Bed, Right Time:

In this session you will learn how YNHH and BH approached the challenge to quickly and consistently identify and treat patients who were clinically deteriorating. Clinicians will describe how focusing on variation in surveillance and patient placement practices produced improvements in patient outcomes and costs and how the improvements generated capacity to accommodate additional patients.

In this session you will learn the role that combined EHR, quality and cost data play in providing evidence of the value of specific work flow and patient care improvements for ICU and clinical research patients. e-ICU users will describe how the EHR both supported centralized clinical patient management that improved quality and lowered cost for YNHH and GH. Clinical research leaders will then demonstrate how the EHR improved clinical research patient selection through protocol development and monitoring.

In this session you will learn how YNHHS’ clinical redesign efforts, including early successes and failures, were managed, staffed and monitored, and how efforts evolved over time to include a “redesigned” redesign process. The new process is anchored by a rigorous 90-day project cycle that greatly improved the success rate of selected projects. Managed by a dedicated project management team, evolving variation reduction strategies allow for provider and unit accountability for improvement in care processes.

Understand the synergies between Decision Support and Continuous Improvement. Learn how a strong foundation of advance cost accounting and integrated clinical, financial and operational data can unlock opportunities to drive real improvements in quality and cost within your organization.

Attendees will learn:

How to develop patient populations; see the prevalence, cost and source of hospital acquired conditions and readmissions, and dive deep into financial, operational, and clinical data to identify opportunities for improvement.

How to create workflows to track results on improvement programs and quantify the cost savings, and see the actionable information available to senior leaders, physicians, department leaders and change agents.

How peers are utilizing StrataJazz to prepare for value based payments and CMS reimbursement models such as the Comprehensive Care for Joint Replacement (CCJR).

Hear first-hand how Yale’s “quality-first” approach reduced variation, improved clinical outcomes, and yielded $150M in savings and how you can apply the same approach at your organization. You will have an opportunity to ask questions about how they organized their program, how they overcame skeptics and how they meaningfully engaged physicians as partners.

See a live demo of Strata’s Continuous Improvement solution to learn how your organization can build a successful organizational-wide quality improvement program that drives true cost savings. Learn how you can identify and quantify actionable opportunities to improve quality and reduce utilization among physicians, and see the Yale Quality Variation Indicators in action including pre-built reports, analytics, and algorithms and more.

Attendees will learn:

What you need to operationalize a value improvement program/cost savings program.

How to create workflows to build accountability and drive results.

How to create performance targets and measure results against the targets and timelines.

Thursday, April 28th, 2015

Right Patient, Right Bed, Right Time Initiative - Leveraging the RI to Improve Quality and Reduce Cost

Learn how YNHH’s Right Patient, Right Bed, Right Time initiative leveraged the RI and real-time capabilities to improve quality and reduce cost. Outcomes achieved include reducing mortality 30% at a hospital campus.

Identifying Sepsis at Admission and Predicting Onset in the Hospital Using the Rothman Index

Strategies and Best Practices Utilized by Hospitals to Operationalize the RI

Discuss how leaders leverage the RI to meet clinical and operational needs. Topics include leveraging the RI to predict discharge types and readmission rates in oncology, to manage care through the continuum, to improve communication during interdisciplinary rounding, patient handoffs and unit huddles, and to enhance staffing assignments.

Current and New Product Overview

Discover more about current and new PeraHealth products to expand remote monitoring and analytical capabilities.

Friday, April 29th, 2016

Overview and Purpose of RI Roundtables

Discuss how RI Roundtables can best meet the needs of RI users and researchers.

A: RI Roundtable – Research

Interactive, panel discussion on RI-related research projects.

B: RI Roundtable – Clinical Operations

Interactive, panel discussion on strategies and best practices to hard-wire and operationalize RI.

A: RI Roundtable – Pediatrics

Interactive, panel discussion on the unique opportunities and challenges of leveraging the pRI in the pediatric setting.

B: RI Roundtable – Remote Monitoring

Interactive, panel discussion on the expanded use of the RI in remote monitoring.

Event Registration

Options for presentation selections and other event details that pertain to the individual days will appear on the registration checkout page as well as give you the ability to add on other registration days. Registration is limited